Interpretation of the IASLC ninth edition of the TNM classification for lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHAO Kejia , LIU Chengwu ,  LIU Lunxu

Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Lung cancer; TNM classification; ninth edition; interpretation

DOI：

10.7507/1007-4848.202403015

Video：

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The International Association for the Study of Lung Cancer (IASLC) recently introduced the ninth edition of the TNM classification for lung cancer. This milestone is supported by a comprehensive database comprising 124 581 lung cancer patients from 75 centers across 25 nations between 2011 and 2019. Following the exclusion of incomplete data, the analysis focused on 87 043 patients. These insights guided the modifications in the ninth edition of the TNM classification for lung cancer. The updated classification now includes a higher representation of Asian patients, particularly showing significant growth among Chinese patients. This revised classification will offer more pertinent benchmarks for the diagnosis and prognostic assessment of lung cancer. This article delves into the database updates, stage adjustments, and rationale behind the IASLC ninth edition of the TNM classification for lung cancer.

Citation： ZHAO Kejia, LIU Chengwu, LIU Lunxu. Interpretation of the IASLC ninth edition of the TNM classification for lung cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(4): 489-497. doi: 10.7507/1007-4848.202403015 Copy

1.	UICC. TNM Classification of Malignant Tumours, first edition 1968. URL: https://www.uicc.org/who-we-are/about-uicc/uicc-and-tnm. Accessed on 2024-03-14.
2.	AJCC. Manual for Staging of Cancer, Frist edition1977. URL: https: //cancerstaging. org/references-tools/deskreferences/Pages/default. aspx. Accessed on 2024-03-14.
3.	UICC. TNM Classification of Malignant Tumours, fourth edition 1987. URL: https://www.uicc.org/who-we-are/about-uicc/uicc-and-tnm. Accessed on 2024-03-14.
4.	Goldstraw P, Crowley J. The International Association for the Study of Lung Cancer International Staging Project on Lung Cancer. J Thorac Oncol, 2006, 1(4): 281-286.
5.	Rami-Porta R, Ball D, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol, 2007, 2(7): 593-602.
6.	Rusch VW, Crowley J, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the N descriptors in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol, 2007, 2(7): 603-612.
7.	Postmus PE, Brambilla E, Chansky K, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification of lung cancer. J Thorac Oncol, 2007, 2(8): 686-693.
8.	Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol, 2007, 2(8): 706-714.
9.	Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
10.	Rami-Porta R, Bolejack V, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: The new database to inform the eighth edition of the TNM classification of lung cancer. J Thorac Oncol, 2014, 9(11): 1618-1624.
11.	Rami-Porta R, Nishimura KK, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groups in the forthcoming (ninth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2024. Epub ahead of print.
12.	Asamura H, Nishimura KK, Giroux DJ, et al. IASLC Lung Cancer Staging Project: The new database to inform revisions in the ninth edition of the TNM classification of lung cancer. J Thorac Oncol, 2023, 18(5): 564-575.
13.	Van Schil PE, Asamura H, Nishimura KK, et al. The IASLC Lung Cancer Staging Project: Proposals for the revisions of the T descriptors in the forthcoming ninth edition of the TNM classification for lung cancer. J Thorac Oncol, 2023. Epub ahead of print.
14.	Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol, 2015, 10(12): 1675-1684.
15.	Huang J, Osarogiagbon RU, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the N descriptors in the forthcoming 9th edition of the TNM classification for lung cancer. J Thorac Oncol, 2023. Epub ahead of print.
16.	Eberhardt WE, Mitchell A, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol, 2015, 10(11): 1515-1522.
17.	Fong KM, Rosenthal A, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the M descriptors in the forthcoming 9th edition of the TNM classification of lung cancer. J Thorac Oncol, 2024. Epub ahead of print.
18.	Giaj-Levra N, Giaj-Levra M, Durieux V, et al. Defining synchronous oligometastatic non-small cell lung cancer: A systematic review. J Thorac Oncol, 2019, 14(12): 2053-2061.
19.	Blumenthaler AN, Antonoff MB. Classifying oligometastatic non-small cell lung cancer. Cancers(Basel), 2021, 13(19): 4822.
20.	Detterbeck FC, Asamura H, Rami-Porta R, et al. The only constant is change: Introducing the International Association for the Study of Lung Cancer proposals for the ninth edition of TNM stage classification of thoracic tumors. J Thorac Oncol, 2023, 18(10): 1258-1260.

1. UICC. TNM Classification of Malignant Tumours, first edition 1968. URL: https://www.uicc.org/who-we-are/about-uicc/uicc-and-tnm. Accessed on 2024-03-14.
2. AJCC. Manual for Staging of Cancer, Frist edition1977. URL: https: //cancerstaging. org/references-tools/deskreferences/Pages/default. aspx. Accessed on 2024-03-14.
3. UICC. TNM Classification of Malignant Tumours, fourth edition 1987. URL: https://www.uicc.org/who-we-are/about-uicc/uicc-and-tnm. Accessed on 2024-03-14.
4. Goldstraw P, Crowley J. The International Association for the Study of Lung Cancer International Staging Project on Lung Cancer. J Thorac Oncol, 2006, 1(4): 281-286.
5. Rami-Porta R, Ball D, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the T descriptors in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol, 2007, 2(7): 593-602.
6. Rusch VW, Crowley J, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the N descriptors in the forthcoming seventh edition of the TNM classification for lung cancer. J Thorac Oncol, 2007, 2(7): 603-612.
7. Postmus PE, Brambilla E, Chansky K, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the M descriptors in the forthcoming (seventh) edition of the TNM classification of lung cancer. J Thorac Oncol, 2007, 2(8): 686-693.
8. Goldstraw P, Crowley J, Chansky K, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol, 2007, 2(8): 706-714.
9. Goldstraw P, Chansky K, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
10. Rami-Porta R, Bolejack V, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: The new database to inform the eighth edition of the TNM classification of lung cancer. J Thorac Oncol, 2014, 9(11): 1618-1624.
11. Rami-Porta R, Nishimura KK, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for revision of the TNM stage groups in the forthcoming (ninth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2024. Epub ahead of print.
12. Asamura H, Nishimura KK, Giroux DJ, et al. IASLC Lung Cancer Staging Project: The new database to inform revisions in the ninth edition of the TNM classification of lung cancer. J Thorac Oncol, 2023, 18(5): 564-575.
13. Van Schil PE, Asamura H, Nishimura KK, et al. The IASLC Lung Cancer Staging Project: Proposals for the revisions of the T descriptors in the forthcoming ninth edition of the TNM classification for lung cancer. J Thorac Oncol, 2023. Epub ahead of print.
14. Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol, 2015, 10(12): 1675-1684.
15. Huang J, Osarogiagbon RU, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the N descriptors in the forthcoming 9th edition of the TNM classification for lung cancer. J Thorac Oncol, 2023. Epub ahead of print.
16. Eberhardt WE, Mitchell A, Crowley J, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol, 2015, 10(11): 1515-1522.
17. Fong KM, Rosenthal A, Giroux DJ, et al. The IASLC Lung Cancer Staging Project: Proposals for the revision of the M descriptors in the forthcoming 9th edition of the TNM classification of lung cancer. J Thorac Oncol, 2024. Epub ahead of print.
18. Giaj-Levra N, Giaj-Levra M, Durieux V, et al. Defining synchronous oligometastatic non-small cell lung cancer: A systematic review. J Thorac Oncol, 2019, 14(12): 2053-2061.
19. Blumenthaler AN, Antonoff MB. Classifying oligometastatic non-small cell lung cancer. Cancers(Basel), 2021, 13(19): 4822.
20. Detterbeck FC, Asamura H, Rami-Porta R, et al. The only constant is change: Introducing the International Association for the Study of Lung Cancer proposals for the ninth edition of TNM stage classification of thoracic tumors. J Thorac Oncol, 2023, 18(10): 1258-1260.

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Interpretation of the IASLC ninth edition of the TNM classification for lung cancer

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